Bring Your Brooms! How to Clean Up Patient Ledgers
I often hear from patients, “Why do I have a balance?”
Let’s uncover the easiest way to audit a patient’s ledger and determine exact balances. This will keep your head straight and your account clear and show your patients that billing is the last issue they should have!
Many years ago, I was beginning my journey into Insurance Claims and AR. My office manager at the time, a true GEM, shared with me a document that I had developed over the years into a live spreadsheet. This helps show patients exactly where their balance comes from and allows you and your team to understand better balancing patients’ ledgers.
Step 1
Determine where you will start the audit.
I like to begin when the patient’s ledger is $0. This may mean going back a few years, but trust me—it’s worth it.
Step 2
Collect each explanation of benefits statement for the dates of service being audited. (NOTE: Primary and secondary if there is a secondary plan)
Step 3
With each date of service entered into column A, add up the procedures for the first date of service. Enter that number into column B – Charges.
Step 4
In column C, you’ll enter what Primary Insurance paid. If there is a secondary, that will go in column D. If there is no secondary, you can hide that column.
Step 5
Adjustments, column E, is where you’ll add or subtract any needed adjustments.
For example, if you posted a certain fee, but the insurance was processed under a different fee schedule, or perhaps you posted office fees to your ledger and adjusted them to the in-network fee.
*TIP: If they are different, ensure you have the correct fee schedule in your system if you post in-network fees in your ledgers.
Step 6
Any payments made by the patient that day will go in column F.
Automatically, the sheet will calculate any balance or credit for that date of service. As you work through each date of service, the sheet will also create a running total.
I then save this sheet as a PDF and put it into the patient’s documents. I will give this (or email) a copy of the information and explain the benefits to the patient.
In my experience, most patients have appreciated the details this breakdown gives and shows that we “go the extra mile” when, in reality, it is a tool that helps keep our billing department and accounts in check.
This will help with not only balances but also credits!
TIP:
While this may seem overwhelming at first, it gets easier! Soon, you’ll be able to fly through account audits. Clean accounts mean happy patients AND a happy doctor!
Here is a link to this spreadsheet. Open the link and save a local copy on your computer.
Happy Cleaning!
About the Author
Tiffany Yeckel, FAADOM
Tiffany Yeckel, a Virginia native, started in dental over 11 years ago. She was inspired to work in dentistry because of her experiences as a patient with the dentist, and she now manages the practice!
She enjoys being able to connect with patients who are undergoing procedures that she has experienced first-hand.
Tiffany has been a member of AADOM since 2019, and she received her Fellowship (FAADOM) in 2022.
